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Changes to Employee Information

City of Madison Information

The City of Madison needs up to date employee home address and telephone numbers. All employees are required to provide their department/division heads or designees with up to date home addresses and telephone numbers within 10 working days of changes in address and/or phone number. The Change of Address or Telephone Number Form should be submitted to the employee's Payroll Clerk. See APM 2-37.

Family status change may include Marriage, Divorce, Creation or Termination of Domestic Partnership, Birth of Child, Adoption of Child, Pre-Adoption Placement of Child, Start of Guardianship of Child, Death of Family Member, or Dependent No Longer Eligible for Coverage Due to Age.

Beneficiary Change: A divorce, annulment, or similar event will NOT invalidate a Beneficiary Designation which named a former spouse or domestic partner. To remove a former spouse or domestic partner as beneficiary, the employee must file a new designation form. If a minor child is listed as a beneficiary, the benefit will not be distributed until a court-appointed guardian has been named. That guardian will be given limited discretion to manage the benefit proceeds.

Time Limits for Qualifying Events

There are time limits for form submittal due to family status changes. In order to make changes to insurance or other benefits, you must declare the change in family status by the required date.

30-day application requirement

The following family status changes have a 30 day application requirement for ETF (Health and Retirement).​

May not be an exhaustive list.

Marriage

Creation of domestic partnership

Loss of eligibility for other medical coverage or employer contribution for other coverage

Legal guardianship granted

Dependent loss of eligibility for other coverage

Child age 26 or older becomes disabled

Return to work after leave or layoff (with coverage lapse due to nonpayment of premiums)

31-day application requirement

The following changes to life Insurance coverage must be made within 31 days of a family status change:

Initial enrollment

Increase level of coverage

Add dependent coverage

Increase existing dependent coverage

An increase in life insurance coverage by one level, or addition of dependent unit(s) of coverage may be made within 31 days following the qualifying event that is the basis for the change. A request to increase life insurance coverage by more than one level, or to increase life insurance coverage or add dependent unit(s) of coverage outside of 31 days following a qualifying event, requires an Evidence of Insurability application.

60-day application requirement

The following family status changes have a 60 day application requirement for ETF (Health and Retirement).​

May not be an exhaustive list.

Birth of a child, adoption of a child, or placement of a child for adoption

Single mother/father declaring parentage and changing to Family coverage (date of birth start)

National Medical Support Notice (see ETF information)

Open Enrollment Health Coverage Changes

In the absence of a qualifying event, the following family status changes to Health Coverage may only be made during Open Enrollment in the fall.